Concussions: Football’s Faux Pas

San Francisco 49’ers quarterback Steve Young lies motionless on field after suffering a concussion against the Arizona Cardinals in 1999. He never played again. (AP/Scott Troyanos)

Concussions are the faux pas of football. Injuries are bad enough, but concussions are even worse. Brain damage from repeated poundings on the football field leave retired players to deal with depression, dementia and even the dirge of death. Big men are reduced to helplessness because of concussions and what we now call CTE: Chronic traumatic encephalopathy.

CTE was discovered by neuropathologist Dr. Bennet Omalu and is the subject of the film “Concussion” starring Will Smith. It’s a must see.

Speaking of concussions, one coach said that “having watched football for a very long time I have to agree that the helmet is designed more like a weapon and less like a protective device.” Another coach said this: “the hit didn’t look that bad.” He had seen his star defensive player withstand far worse. But still, there Chris Beranger was, laying on the turf after colliding with a teammate near the goal line.

“Discombobulated,” is the description that Sean McDonnell, coach of the University of New Hampshire’s football team, uses when describing players in these moments. “He wanted to play still, and we said, ‘No, you can’t.” That was the last down Beranger, who had suffered a concussion, would play. “The effects kept lingering and linger and lingering,” said. McDonnell.

Helmets are necessary but some say they also provide a myth of protection. The idea has roots in years of scientific research, even in the mythology of football itself. Called risk compensation or risk homeostasis, it’s a theory that holds that protections can actually increase reckless behavior.

In 2009, Pope Bennedict XVI traveled into the heart of Cameroon — and the African AIDs epidemic — and proclaimed condoms “increases the problem” of HIV transmission. The backlash was immediate and absolute. The Washington Post even reprinted a cartoon that depicted the Pope lauding Africans dying of disease: “Blessed are the sick, for they have not used condoms.”

But some social scientists — who disagreed with his politics — said the pontiff may have been referring to risk compensation. “When people think they’re made safe by using condoms at least some of the time, they actually engage in riskier sex,” Harvard researcher Edward C. Green wrote in an editorial in the Post. The same, some research has shown, goes for skiing with a helmet. One study, which analyzed more than 700 skiers and was published in Wilderness & Environmental Medicine, said “helmet use is one of the factors influencing risk-taking on the slopes” for men younger than 35.

Erik Swartz, a University of New Hampshire professor of kinesiology, spent years on the sidelines of football games as an athletic trainer. He understood the sport inside and out. Swartz said “it was the thing that scared me the most,” he said. “The implications if you messed it up and didn’t do [the treatment] right. It could mean they’re a quadriplegic. It could mean death. Everything is on the line.”

Every football season, he said, there came a moment when he had to rush onto the field in fear a player had sustained a catastrophic injury. The helmet, Swartz realized, had convinced players they were safer than they were.

So Swartz started looking into the football helmet, analyzing its trajectory from novelty to cultural behemoth. By the 1950s, the helmet morphed from padded leather to polymer equipped with a mask. Around that time, convinced this new technology had ameliorated the risk of head injury, coaches started counseling a new technique: lead with the head. Another tackling style, called “spearing” — a lunging tackle that leads with the helmet’s crown — soon rose in prominence. These evolutions precipitated a surge in catastrophic injuries. In the late 1960s, more than 20 players died every year of brain injuries, before league rules prohibited that style.

According to Professor Swartz, the fundamental cause of concussions is behavior. And so Swartz is advocating the simple act of removing the helmet during training drills in order to train players to tackle with greater caution. The idea is to heighten their instinct to protect their heads, then hope that caution would carry over into real games when they wore their helmets, thereby diminishing the chance of a concussion.